Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Facility		$5.00	$5.00	$5.00
Aetna Facility/Professional Professional Modifier Low / Median / High Price $5.00 / $5.00 / $5.00	Professional		$5.00	$5.00	$5.00
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $57.55 / $69.31 / $183.24	Facility		$57.55	$69.31	$183.24
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $14.33 / $2,500.00 / $2,500.00	Professional		$14.33	$2,500.00	$2,500.00
Blue Shield Facility/Professional Professional Modifier Low / Median / High Price $217.89 / $306.23 / $449.40	Professional		$217.89	$306.23	$449.40
Cigna Facility/Professional Facility Modifier Low / Median / High Price $22.55 / $22.55 / $22.55	Facility		$22.55	$22.55	$22.55
Cigna Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $19.17 / $22.55	Professional		$19.17	$19.17	$22.55
Contra Costa Health Facility/Professional Professional Modifier Low / Median / High Price $3.06 / $3.06 / $3.06	Professional		$3.06	$3.06	$3.06
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $393.93 / $638.07 / $801.00	Professional		$393.93	$638.07	$801.00
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $90.00 / $100.00 / $100.00	Facility		$90.00	$100.00	$100.00
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1.49 / $1.49 / $1.49	Professional		$1.49	$1.49	$1.49
Molina Facility/Professional Professional Modifier Low / Median / High Price $70.00 / $70.00 / $85.00	Professional		$70.00	$70.00	$85.00
Providence Facility/Professional Facility Modifier Low / Median / High Price $5.00 / $5.00 / $22.55	Facility		$5.00	$5.00	$22.55
Providence Facility/Professional Professional Modifier Low / Median / High Price $19.17 / $19.17 / $22.55	Professional		$19.17	$19.17	$22.55